The latest hypertension standard revision! The latest antihypertensive program is introduced, which is closely related to every hypertensive person
On May 6, the International Society of Hypertension (ISH) officially released the 2020 edition of the International Hypertension Practice Guidelines. The new guidelines have partially revised the grading of hypertension and the recommendations for medication for hypertension, which are closely related to each of us with hypertension.
The new guidelines introduce two management standards, the "basic standard" and the "best standard", the basic standard is the minimum standard. The blood pressure target, the basic standard recommendation is preferably lower than 140/90 mmHg, and the minimum reduction is 20/10 mmHg.
- Different blood pressure targets:
The optimal standard is that for young and middle-aged people, the target blood pressure should be <130/80 mmHg (not lower than 120/70 mmHg); in previous guidelines, it was not suggested that it should not be lower than 120/70 mmHg.
Old guidelines only require blood pressure below 120/80 to be normal blood pressure, but there are no special requirements for the lower limit. The new guidelines point out that for young and middle-aged hypertensive patients, blood pressure should be lowered to below 130/80, but it is not recommended to be lower. Of course, in reality, it is difficult for us to achieve no higher than 130/80 and no lower than 120/70. It’s just that everyone has A new concept, blood pressure is not as low as possible, let's do the first step to reduce it to 130/80!
- The grading of hypertension is simplified, from the original three-level to the current two-level
New guidelines for blood pressure classification:
140-159/90-99 for grade 1 hypertension
≥160/100 is grade 2 hypertension
The blood pressure greater than 180/110 in the old guideline belongs to grade 3 hypertension, and the concept of grade 3 hypertension has been cancelled.
That is, the original grade 2 hypertension and grade 3 hypertension are combined into grade 2 hypertension; this may indicate that as long as the blood pressure is higher than the standard of 160/100, the risk is very high.
So don't be lucky for those who had grade 3 hypertension, this is a medical grade, not the original grade 3 is now grade 2, and the risk is reduced. What's more, the original level 2 and level 3 belong to the more dangerous level.
Not only the classification of hypertension has been revised, but also the risk stratification has been adjusted, and the stratification has been simplified: very high risk has been canceled, and it has been merged into high risk.
- What other changes are there?
In terms of diagnosis of hypertension, there is only one high blood pressure in the office, and hypertension cannot be diagnosed. Usually 2-3 in-office measurements are required every 1-4 weeks (depending on blood pressure level) to confirm the diagnosis of hypertension. The previous requirement was that the blood pressure was higher than 140/90 three times on different days. Now, the different days are changed to 1-4 weeks, which means more time is given to rule out the temporary increase of blood pressure caused by the interference of other factors.
Home blood pressure monitoring or 24-hour ambulatory blood pressure monitoring is more recommended, which is more accurate than office blood pressure, that is, hospital monitoring stations.
Changes in drug treatment
The specific best standard is recommended. Pril, sartan, dipine and diuretics can be used in monotherapy.
The effect of a single drug is not up to the standard, and the ideal solution is to use a single-piece compound preparation.
When the effect of monotherapy is not good, adjust the medication according to the following 4 steps:
A. Low-dose Puli/Sartan + Dipine;
B. Full dose of Puli/Sartan + Dipine;
C. On the basis of Puli/Sartan + Dipine + diuretic;
D. Puli/sartan + dipine + diuretic + spironolactone.
Although the grading of hypertension has changed, the previous grades 2 and 3 have been merged into grade 2 hypertension, but we prevent high blood pressure, control high blood pressure, and manage high blood pressure will never change!
Adhering to a long-term healthy lifestyle is the basis for controlling high blood pressure and will not change!
Adhere to a healthy lifestyle throughout a person's life!